314-953-5800; FAX 314-953-5813
Hazelwood West High School
#1 Wildcat Lane
Hazelwood, MO 63042
Please return this completed form to the A+ office.
After-School Tutoring Application
Student Name: ________________________________________________________ Class: _________ Student ID#: ___________
First Last
I would prefer to work at:
Elementary School: (Usually after regular school hours)
□ Monday □ Tuesday □ Wednesday □ Thursday □ Friday
□ Russell □ McCurdy □ Lusher □ Armstrong □ McNair □ Garrett □ Lawson
□ Other____________________
Middle Schools: (Usually after regular school hours)
□ Monday □ Tuesday □ Wednesday □ Thursday □ Friday
□ Northwest Middle □ West Middle
West High School □ Monday □ Tuesday □ Wednesday □ Thursday □ Friday
□ Math □ Social Studies □ Science □ English □ Languages (Specify) ___________ Other __________
I understand that I will need to secure my own transportation to the tutoring site. I have read the tutoring procedures and policies and agree to them. I understand that if I must miss an assigned tutoring session, I must notify the tutoring site. If I miss three tutoring sessions without notification,
I will be placed on probation and possibly dropped from the A+ Program.
Student Signature: _______________________________________ Parent Signature: _________________________________
*Students must have a minimum cumulative 2.5 GPA, 95% cumulative attendance, and no more than 12 days combined ISS/OSS for fours year while enrolled in the Hazelwood School District in order to maintain A+ eligibility.